Cetuximab/Irinotecan-Chemotherapy in KRAS Wild-type Pretreated Metastatic Colorectal Cancer: A Pooled Analysis and Review of Literature.

ISSN: 1876-1038 (Online)
ISSN: 1574-8871 (Print)


Volume 9, 4 Issues, 2014


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Editor-in-Chief:
Alberto Zaniboni
Oncologia Medica, Fondazione Poliambulanza
Berscia
Italy


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Cetuximab/Irinotecan-Chemotherapy in KRAS Wild-type Pretreated Metastatic Colorectal Cancer: A Pooled Analysis and Review of Literature.

Author(s): Sandro Barni, Mara Ghilardi, Karen Borgonovo, Mary Cabiddu, Alberto Zaniboni and Fausto Petrelli

Affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio-Caravaggio, Piazzale Ospedale 1, 24047 Treviglio (BG), Italia.

Abstract

Introduction: Cetuximab and irinotecan are effective agents in advanced colorectal cancer (CRC) after either irinotecanor oxaliplatin-based first-line chemotherapy. Here, the efficacy of this combination in patients with the KRAS wild-type gene as second- or further-line therapy is reviewed and data are collected in a pooled analysis.

Methods: Studies that enrolled pretreated CRC patients for second-line therapy or beyond were identified using electronic databases (PubMed and EMBASE). A systematic analysis was conducted using Comprehensive Meta Analysis (version 2.2.064) to calculate the event rate of response and the 95% confidence interval. The weighted median overall survival (OS) and progression-free survival (PFS) were also calculated with NCSS 2007 software. We tested for significant heterogeneity using Cochran’s chi-square test and the I2 index.

Results: Twenty-five studies published between 2007 and 2012 were eligible for this analysis, with a total of 1,712 KRAS wild-type patients enrolled. The overall response rate was 31.9% with similar response rates of 28.7% for second-line treatment and 31.1% for third or further lines. The overall weighted median OS and PFS were 12.5 and 6 months with a weighted OS of 11.56 and 12.2 months for second- and further-line CRC settings, respectively.

Conclusion: In metastatic KRAS wild-type CRC patients pretreated with one or more lines of therapy, cetuximab plus irinotecan-based chemotherapy is an active treatment. Response rates and survival outcomes appear similar in second-line therapy or beyond.


Keywords: Colorectal cancer, cetuximab, irinotecan, KRAS wild type, second line, pooled analysis.

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Article Details

Volume: 8
Issue Number: 2
First Page: 101
Last Page: 109
Page Count: 9
DOI: 10.2174/15748871113089990042
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